Neck pain

Overview

Like back strain, neck strain is an irritation to tendons, muscles
and ligaments in the upper back and neck area. Whiplash is characterized
by a collection of symptoms that occur following damage to the neck, usually
because of sudden extension and flexion, such as in a car accident.
[top]

Causes

Sometimes neck strain can be brought on by an abrupt movement by the neck,
such as whiplash.
[top]

Symptoms such as neck pain may be present directly after the injury or
may be delayed for several days. In addition to neck pain, other symptoms
may include neck stiffness, injuries to the muscles and ligaments (myofascial
injuries), headache, dizziness, abnormal sensations such as burning or
prickling (paresthesias), or shoulder or back pain. In addition, some
people experience cognitive, somatic, or psychological conditions such
as memory loss, concentration impairment, nervousness/irritability, sleep
disturbances, fatigue or depression.
[top]

Diagnosis

Outlined below are some of the diagnostic tools that your physician may
use to gain insight into your condition and determine the best treatment
plan for your condition.

Medical history: Conducting a detailed medical history
helps the doctor better understand the possible causes of your back
and neck pain which can help outline the most appropriate treatment.

Physical exam: During the physical exam, your physician
will try to pinpoint the source of pain. Simple tests for flexibility
and muscle strength may also be conducted.

X-rays are usually the first step in diagnostic testing
methods. X-rays show bones and the space between bones. They are of
limited value, however, since they do not show muscles and ligaments.

MRI (magnetic resonance imaging) uses a magnetic field
and radio waves to generate highly detailed pictures of the inside of
your body. Since X-rays only show bones, MRIs are needed to visualize
soft tissues like discs in the spine. This type of imaging is very safe
and usually pain-free.

CT scan/myelogram: A CT scan is similar to an MRI in
that it provides diagnostic information about the internal structures
of the spine. A myelogram is used to diagnose a bulging disc, tumor,
or changes in the bones surrounding the spinal cord or nerves. A local
anesthetic is injected into the low back to numb the area. A lumbar
puncture (spinal tap) is then performed. A dye is injected into the
spinal canal to reveal where problems lie.

Electrodiagnostics: Electrical testing of the nerves
and spinal cord may be performed as part of a diagnostic workup. These
tests, called electromyography (EMG) or somato sensory evoked potentials
(SSEP), assist your doctor in understanding how your nerves or spinal
cord are affected by your condition.

Bone scan: Bone imaging is used to detect infection,
malignancy, fractures and arthritis in any part of the skeleton. Bone
scans are also used for finding lesions for biopsy or excision.

Discography is used to determine the internal structure
of a disc. It is performed by using a local anesthetic and injecting
a dye into the disc under X-ray guidance. An X-ray and CT scan are performed
to view the disc composition to determine if its structure is normal
or abnormal. In addition to the disc appearance, your doctor will note
any pain associated with this injection. The benefit of a discogram
is that it enables the physician to confirm the disc level that is causing
your pain. This ensures that surgery will be more successful and reduces
the risk of operating on the wrong disc.

Injections: Pain-relieving injections can relieve back
pain and give the physician important information about your problem,
as well as provide a bridge therapy.

Treatment

Treatment for individuals with neck strain may include pain medications,
nonsteroidal anti-inflammatory drugs, antidepressants, muscle relaxants,
and a cervical collar (usually worn for two to three weeks). Range of
motion exercises, physical therapy, and cervical traction may also be
prescribed. Supplemental heat application may relieve muscle tension.

Generally, prognosis for individuals with neck strain is
good. The pain clears within a few days or weeks. Most patients recover
within 3 months after the injury, however, some may continue to have residual
neck pain and headaches.
[top]

FAQs

When is neck strain serious?

As with back pain, any time symptoms do not improve after three days,
it's a good idea to see a spine specialist. Also, red flag symptoms like
pain or numbness radiating into an arm, especially down into the fingers,
are emergency symptoms and should be seen by a spine specialist within
48 hours, or you risk permanent damage.